Pain management nursing : official journal of the American Society of Pain Management Nurses
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Review
An Integrative Review of Interventions to Support Parents When Managing Their Child's Pain at Home.
To identify interventions aimed at helping parents manage their child's pain at home and to establish which aspects of interventions were effective. Integrative narrative review. MEDLINE, CINAHL Plus, PsychINFO, PsychArticles, AMED, PubMed, Scopus and Web of Knowledge databases were searched in 2016. ⋯ Successful interventions will be tailored to the child and adequately powered. Including a measure of sedation will ensure sedation is not mistaken for analgesic effectiveness. Interventions should address multiple facets of pain management and include a measure of pain over a period as opposed to a snapshot in time.
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Randomized Controlled Trial
Effects of Educational Intervention on State Anxiety and Pain in People Undergoing Spinal Surgery: A Randomized Controlled Trial.
Preoperative educational intervention for anxiety and pain affects patients undergoing spinal surgery. The effects, however, have never been examined using randomized controlled designs. To investigate the effects of education on anxiety and pain for patients undergoing spinal surgery, a randomized trial with block design was used. ⋯ Patients had their anxiety (using the State-Trait Anxiety Inventory; STAI) and pain (using a visual analog scale) measured the day before surgery, 30 minutes before surgery, and the day after surgery. After controlling for demographics, the adjusted anxiety and pain levels were significantly lower for the Intervention group: mean STAI scores were 52.67 at baseline and 47.54 at 30 minutes before surgery (p < .001); mean pain scores were 6.07 at baseline and 5.28 on day after surgery (p < .001). Preoperative educational intervention is effective in informing patients undergoing spinal surgery that can lead to a reduction in pain, anxiety, and fear postoperatively.
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Observational Study
Does Neurofunction Monitoring Enhance Nursing Confidence and Comfort?
Despite advances in the science of sedation and pain assessment, few studies have examined the impact of various assessment tools on nursing confidence. This study examines how bispectral index monitoring impacts nursing confidence in the assessment and comfort in medication administration based on that assessment. ⋯ From 110 nurse surveys, nurses had higher confidence assessing pain and sedation when BIS monitor was used in concert with RASS assessments for patients with neuromuscular blockade agents. There was no different in confidence in- nor comfort with- sedation and pain assessments for patients not receiving neuromuscular blockade agents.
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The objectives of this study were to examine association between a family history of substance abuse and admission morphine equivalent dose, depression and pain catastrophizing screening scores, as well as reported personal history of substance use. The retrospective research was completed in an interdisciplinary three-week pain rehabilitation center. The subject cohort included admissions from January through December 2014 with 351 datasets for family history of substance abuse and oral morphine equivalency and 341 for depression, pain catastrophizing and use of substances. ⋯ Those with a positive family history endorsed greater frequency of past alcohol use χ2 (1, N = 326) = 6.67, p = 0.1 and marijuana use χ2 (1, N = 341) = 4.23, p = .04 and past χ2 (1, N = 329) = 9.90, p = .002 and current tobacco use χ2 (1, N = 327) = 8.81, p = .003. Use of family history of substance abuse information may help provide data for multimodal treatments of chronic non-cancer-pain. The findings from this study can be used to guide future research.
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Postoperative pain is considered a major, complex and multidimensional problem that affects the clinical and functional outcomes of patients and may contribute to increased postoperative complications. The goal of this study was to determine the prevalence of inadequate pain control and to investigate the factors associated with inadequate pain control among postoperative cancer patients. A descriptive correlational, cross-sectional design was used. ⋯ The intravenous route was associated with increased odds of poor pain control at rest and on movement (OR = 2.279, p = .016, and OR = 5.393, p = .012) compared with other routes, including combinations of the intravenous and oral or epidural route. Chronic use of pain medications and older age were predictors of inadequate pain control postoperatively. Administration of preemptive medications and of combinations of fentanyl and bupivacaine via the epidural route was associated with better pain control.